Leading grunge band Alice in Chains had a song 'God Smack', which included the line 'stick your arm for some real fun', a reference to injecting heroin.

Tim Jonze from The Guardian states that '.heroin had blighted the scene ever since its inception in the mid-80s' and he argues that the '.involvement of heroin mirrors the self-hating, nihilistic aspect to the music' in addition to the heroin deaths, Jonze points out that Stone Temple Pilots' Scott Weiland, as well as Courtney Love, Mark Lanegan and Evan Dando '.all had their run-ins with the drug, but lived to tell the tale.' A 2014 book stated that whereas in the 1980s, people used the 'stimulant' cocaine to socialize and '.celebrate good times', in the 1990s grunge scene, the 'depressant' heroin was used to 'retreat' into a 'cocoon' and be '.sheltered from a harsh and unforgiving world which offered.few prospects for.change or hope.' In the 1990s, the media focused on the use of heroin by musicians in the Seattle grunge scene, with a 1992 New York Times article listing the city's 'three principal drugs' as ' espresso, beer and heroin' and a 1996 article calling Seattle's grunge scene the '.subculture that has most strongly embraced heroin'. In the early 1990s, the rise of the grunge alternative rock music and subculture in Seattle brought media attention to the use of heroin by prominent grunge artists. In film, the heroin chic trend in fashion coincided with a string of films throughout the 1990s-such as The Basketball Diaries, Singles, Trainspotting, Kids, Permanent Midnight, and Pulp Fiction-that examined heroin use and drug culture. Heroin infiltrated pop culture through attention brought to addictions in the early 1990s. Gia Carangi, who some call the 'first supermodel' is remembered for being the origin of the heroin chic trend. These changes decreased the stigma surrounding the drug, allowing heroin to find a new market among the middle-class and the wealthy, in contrast to its previous base of the poor and marginalized. Available heroin had become more pure, and snorting became a more common mode of heroin use. In the 1980s, the AIDS epidemic had made injecting heroin with unclean needles increasingly risky. The price of heroin had decreased, and its purity had increased dramatically.

At the time during which heroin chic emerged, the popular image of heroin was changing for several reasons.

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